Division of Clinical Cancer Epidemiology, Department of Oncology and Pathology, Karolinska Institutet, Karolinska University Hospital-Huddinge, Stockholm, Sweden.
BJU Int. 2011 Jul;108(2):196-203. doi: 10.1111/j.1464-410X.2010.09815.x. Epub 2010 Nov 2.
• To describe and compare long-term defecation disturbances in patients who had undergone a cystectomy due to urinary bladder cancer with non-continent urostomies, continent reservoirs and orthotopic neobladder urinary diversions.
• During their follow-up we attempted to contact all men and women aged 30-80 years who had undergone cystectomy and urinary diversion at seven Swedish hospitals. • During a qualitative phase we identified defecation disturbances as a distressful symptom and included this item in a study-specific questionnaire together with free-hand comments. The patients completed the questionnaire at home. • Outcome variables were dichotomized and the results are presented as relative risks with 95% confidence interval.
• The questionnaire was returned from 452 (92%) of 491 identified patients. Up to 30% reported problems with the physiological emptying process of stool (bowel movement, sensory rectal function, awareness of need for defecation, motoric rectal and anal function, straining ability). • A sense of decreased straining capacity was reported by 20% of the men and women with non-continent urostomy and 14% and 8% of those with continent reservoirs and orthotopic neobladders, respectively.
• Of the cystectomized individuals 30% reported problems with the physiological emptying process of stool (bowel movement, sensory rectal function, awareness of need for defecation, motoric rectal and anal function, straining ability). • Those wanting to improve the situation for bladder cancer survivors may consider communicating before surgery the possibility of stool-emptying problems, and asking about them after surgery.
在随访期间，我们试图联系在瑞典七家医院接受膀胱切除术和尿流改道的所有 30-80 岁的男性和女性患者。
在定性阶段，我们将排便障碍确定为一种痛苦的症状，并将此项目纳入一项特定于研究的问卷中，同时还包括自由评论。患者在家中完成问卷。
因变量为二分类变量，结果以 95%置信区间的相对风险表示。
从 491 名确定的患者中，有 452 名（92%）返回了问卷。多达 30%的患者报告存在粪便生理排空过程的问题（排便、直肠感觉功能、排便意识、直肠和肛门运动功能、用力能力）。
20%的非可控性尿流改道术患者、14%的可控性储尿囊患者和 8%的原位新膀胱患者报告存在排便能力下降的感觉。
30%的膀胱切除术后患者报告存在粪便生理排空过程的问题（排便、直肠感觉功能、排便意识、直肠和肛门运动功能、用力能力）。
那些希望改善膀胱癌幸存者状况的人可能会考虑在手术前沟通排空粪便问题的可能性，并在手术后询问相关问题。
